Choosing pain relief for your labour and birth

There are many types of pain relief you can choose form to help you cope with the pain of contractions during labour. From epidural, pethidine, hot water, homeopathy and gas and air, thinking about pain relief before you go into labour means you’ll be as prepared as you can be – and that you’ll find yourself in the most appropriate environment for you to give birth in. “Some women want to work with their pain and are best suited to a birth centre or independent midwife,” says Victoria Cerins, childbirth educator and founder of Birthready. “If you want to avoid pain during labour, a private obstetrician is more for you. Make sure you’ve got a good match between you and the people around you.”

Epidural

An anaesthetic injected into the lower part of your spine to numb the nerves that feel the pain of contractions, an epidural can be used from early labour until you’re fully dilated. Positives include being able to top up the epidural yourself and progressing labour if you’re exhausted, while negatives may include the use of urinary catheter and shivering, nausea and vomiting – epidurals can also inhibit your ability to push effectively when the time comes. It may also affect bonding with your baby after birth and some women complain of backache afterwards.

Also remember that if you ask your midwife for an epidural in the later stages of labour, it may be too late (which often turns out to be a positive if you were hoping for a natural birth).

Warm water

A bath that can be filled with hot water is installed in most birth centres and some labour wards. Filled with water at 35-38°C that’s deep enough to reach your armpits, sitting or lying in the bath helps ease the more intense contractions. “Warm water can help women feel relaxed, calm and more in control,” confirms Renee Adair, founder of the Australian Doula College. “But it can slow labour if you get in too soon – never use the hot tub unless you’re in established labour, as the hot water can be very draining.”

Pethidine

A painkiller from the same family as morphine, pethidine works by relaxing your body and involves an injection in your thigh or bottom, administered by a midwife. It takes about 20 minutes to have effect and lasts around two to three hours, causing drowsiness and dulling pain. Side effects can include slowing labour and, if it crosses the placenta it can affect your baby’s breathing.

Gas and air

‘Happy gas’ - a mixture of oxygen and nitrous oxide - is inhaled through a rubber mask placed over your mouth and is often used towards the end of the first stage of labour, when you breathe deeply through the mouthpiece. The gas builds up in your blood, relaxing your muscles as the contraction builds. Some women don’t like it, however, as it can cause light-headedness, disorientation and a dry mouth. Gas is most effective if you breathe it in as you feel the contraction approaching.

Homeopathy

A natural method of pain relief, homeopaths make up remedies using tiny amounts of compounds from plant and mineral sources containing no chemicals and that can work alongside conventional medicine. Homeopathic remedies can be used to establish labour if it slows down and help with exhaustion as childbirth progresses. “Each remedy is tailor-made for each woman,” says Sydney homeopath Debbie Rayfield, adding that the remedies can also used to help with morning sickness during pregnancy.